(214) 826-4373
toll free (800) 929-2858
info@esihealthcaresolutions.com
Challenging reimbursement environments and regulatory changes has forced rapid evolution in the financial arrangements between physicians and hospitals, changing the focus from volume to value. CAPS monthly model provides quantifiable data to substantiate the volume of uncompensated care, providing an equitable payment system with agreed upon performance expectations.

Compensation Consulting

Aligning Incentives with Reimbursement


We provide analysis and design of physician compensation programs and professional services arrangements to ensure payments are competitive and compliant with fair market value guidelines. The impact of the ACA on healthcare providers will be significant and long lasting. As industry transformation unfolds and insurers march away from fee-for-service toward value-based payments, healthcare organizations must consider how to maintain and improve fiscal health and competitive position - including taking a hard look at physician alignment and compensation. Payment arrangements that have no correlation to productivity and quality are no longer sustainable.

ESI understands the nuances of traditional relationships between hospitals and physicians, as well as the challenges they now face. We know the importance of designing win-win payment arrangements and we have the expertise to develop programs that incorporate innovation, balance, and compliance. 

Features:

+ Innovative strategies that align payments and reimbursement

+ Supports a culture of engagement and high performance

+ Promotes achievement of individual and organizational performance goals

+ Competitive market analysis and benchmarking

+ Ensures payments are fair market value and commercially reasonable

 

In its June 9 Fraud Alert, the U.S. Department of Health and Human Services Office of Inspector General (OIG) puts the industry – and physicians in particular – on notice that it will continue to focus on certain questionable physician compensation arrangements.  The report is available below.
    Government Report: Recent OIG Fraud Alert Targets Physician Compensation Arrangements
Did You Know?

+ Total cash compensation for all physicians increased between 2012 and 2013, but primary care physician pay increased by a greater percentage

+ Incentive payments make up 9% of physician total cash compensation

+ Use of performance-based compensation metrics is increasing with an average payment of $15,000 per metric

 

Recent White Papers
What Our Clients Say

CAPS has provided the much needed structure to make necessary changes to our payment model for professional services between Parkland and UT Southwestern Medical School. It has provided the desired transparency between the two entities. Since 2005, CAPS has allowed our organization to successfully and accurately adjudicate claims payment to the medical school of over $40 million a year.

John Dragovits
Former Executive Vice President and CFO
Parkland Health & Hospital System


Contact Us

Are you ready to learn more about our solutions? Contact us for more information:

(214) 826-4373
toll free (800) 929-2858
info@esihealthcaresolutions.com